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Printing - FECA-PT2 - National Association of Letter Carriers

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2-0700 Exhibit 1: Percentages <strong>of</strong> Entitlement Page 1 (Link to Image)<br />

2-0700 Exhibit 1: Percentages <strong>of</strong> Entitlement Page 2 (Link to Image)<br />

2-0700 Exhibit 2: Entitlement <strong>of</strong> Multiple Payees (Link to Image)<br />

2-0700 Exhibit 3: Sample <strong>Letter</strong> Suspending Benefits When Report <strong>of</strong> Dependents Is Not<br />

Received<br />

Dear NAME OF BENEFICIARY:<br />

I am writing in reference to the compensation benefits you receive from the Office <strong>of</strong> Workers'<br />

Compensation Programs (OWCP).<br />

Section 10.126 <strong>of</strong> the OWCP's regulations states that entitlement to compensation for dependents in<br />

death claims may be suspended for failure to provide timely reports concerning their status. If the<br />

requested information is subsequently received, compensation for dependents is reinstated retroactive to<br />

the date <strong>of</strong> suspension where the evidence submitted supports the payment <strong>of</strong> compensation.<br />

On DATE, Form (CA-12, CA-1617, ETC.) was sent to you for completion. No reply has been received, and<br />

compensation for NAME OF DEPENDENT has been suspended as <strong>of</strong> DATE. If you complete and return the<br />

enclosed copy <strong>of</strong> Form (CA-12, CA-1617, ETC.) compensation will be restored retroactive to the date it<br />

was suspended as long as the information provided shows entitlement to payment.<br />

This is a formal decision, and your appeal rights are attached.<br />

Sincerely,<br />

NAME OF SIGNER<br />

SENIOR CLAIMS EXAMINER<br />

<strong>FECA</strong>-<strong>PT2</strong> Printed: 06/08/2010 121

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